Limb Salvage

Limb salvage surgery is a type of surgery primarily performed to remove bone and soft-tissue cancers occurring in limbs in order to avoid amputation .

Purpose

Limb salvage surgery is performed to remove cancer and avoid amputation, while preserving the patient’s appearance and the greatest possible degree of function in the affected limb. The procedure is most commonly performed for bone tumors and bone sarcomas, but is also performed for soft tissue sarcomas affecting the extremities. This complex alternative to amputation is used to cure cancers that are slow to spread from the limb where they originate to other parts of the body, or that have not yet invaded soft tissue.

Twenty years ago, the standard of care for a patient with a cancer in a limb was to amputate the affected extremity. Limb salvage surgery was an exception to the rule. Today, it is the exception that a patient loses a limb as part of cancer treatment. This is due to improvements in surgical technique, both resection and reconstruction, imaging methods (computed tomography [CT scan] and magnetic resonance imaging [MRI]), and survival rates of patients treated with chemotherapy.

In recent years, limb salvage has been extended more and more to patients severely affected by chronic degenerative bone and joint diseases, such as rheumatoid arthritis, or those facing diabetic limb amputation or acute and chronic limb wounds.

Description

Also called limb-sparing surgery, limb salvage involves removing the cancer and about an inch of healthy tissue surrounding it. In addition, if had been removed, the removed bone is replaced. The replacement can be made with synthetic metal rods or plates (prostheses), pieces of bone (grafts) taken from the patient’s own body (autologous transplant), or pieces of bone removed from a donor body (cadaver) and frozen until needed for transplant (allograft). In time, transplanted bone grows into the patient’s remaining bone. Chemotherapy, radiation, or a combination of both treatments may be used to shrink the tumor before surgery is performed.

Limb salvage is performed in three stages. Surgeons remove the cancer and a margin of healthy tissue, implant a prosthesis or bone graft (when necessary), and close the wound by transferring soft tissue and muscle from other parts of the patient’s body to the surgical site. This treatment cures some cancers as successfully as amputation. Read our success story.